Tonsillectomy

The tonsils help catch germs, such as viruses and bacteria, and prevent them from entering the body through the nose and mouth.

There are three types of tonsil:

• Palatine tonsils, which are at the top of the throat.
• Adenoids or tonsilla pharyngealis, which sit in the nasal cavity.
• Lingual tonsil or tonsilla lingualis, which are in the throat below the palatine tonsils.

Tonsils change in size over time and are typically at their largest in children before becoming smaller in older teens and adults. Children are particularly susceptible to complications, such as breathing problems, when their tonsils grow too large.

A tonsillectomy typically removes the palatine tonsils. In this article, we explain the possible reasons for a tonsillectomy and discuss the procedure and recovery.

What is a tonsillectomy?

A tonsillectomy is a surgical procedure during which a surgeon removes the palatine tonsils from the top of a person's throat. For many years, doctors performed tonsillectomies as a treatment for chronic tonsillitis. More recently, they have started using tonsillectomies to help treat breathing problems, particularly in children. For children and adults, the most likely reasons for needing a tonsillectomy include:

• recurring or chronic bacterial tonsillitis
• sleep apnea
• bothersome snoring
• breathing problems resulting from swollen or enlarged tonsils
• cancer
• bleeding on the tonsils

The practice of using tonsillectomies for treating chronic tonsillitis has declined in recent years because of a growing concern that it may cause more issues than it solves. Also, it does not help treat tonsillitis when a virus is responsible for the infection. A 2018 study involving more than a million people looked at the long-term effects of having a tonsillectomy, an adenoidectomy, or both as a child. The study concluded that these surgeries were responsible for a two- to threefold increase in the number of diseases of the upper respiratory tract later in life. Additionally, the researchers found that the tonsillectomy had little effect on the conditions that it was supposed to be treating. Not all studies are equally negative. For example, a 2015 study concluded that adults who received a tonsillectomy saw an overall improvement in health and quality of life. However, this study was limited to fewer than 100 participants.

Recovery

Shortly after the procedure, the person will wake up in a recovery room. Here, healthcare professionals will monitor the person's vital signs, including their blood pressure and heart rate. Once the person is stable, they will send them home with a detailed care plan. The person will need someone else, such as a friend or family member, to drive them home. They may also need assistance and monitoring for the rest of the day. Doctors will typically prescribe or recommend pain medications based on the person's needs. In addition to medication, the following may aid recovery:

• drinking plenty of fluids
• eating a bland diet consisting of foods that are easy to swallow, such as mashed bananas or applesauce
• resting as much as possible

Complications

Tonsillectomies are a common procedure, but they still carry certain risks. Some potential complications that could occur during or after a tonsillectomy include:

Outlook

A tonsillectomy is a common procedure that doctors use to treat chronic infections of the tonsils or other complications, such as breathing issues or snoring. The procedure is usually safe, but newer research suggests that tonsillectomies may have long-term, adverse effects on health. Before agreeing to a tonsillectomy for themselves or a child, people should discuss any concerns with a doctor.

• reactions to the anesthetic
• bleeding at the surgical site
• swelling
• infection
• fever
• dehydration
• breathing problems